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Dental conebeamct

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  • 1. /7/711 Dental Cone Beam CTDental Cone Beam CT Frank GoernerFrank Goerner Graduate StudentGraduate Student UT-Health Science Center San AntonioUT-Health Science Center San Antonio
  • 2. /7/722 How CBCT WorksHow CBCT Works Similar to currentSimilar to current CT technologyCT technology Uses cone shapedUses cone shaped x-ray beamx-ray beam 2-D flat panel2-D flat panel detectordetector Gives volumetricGives volumetric datadata
  • 3. /7/733 Advantages in Dental ImagingAdvantages in Dental Imaging Lower dose than helical CTLower dose than helical CT Compact designCompact design Superior images to PanoramicSuperior images to Panoramic Low costLow cost Low heat loadLow heat load Dose: Panoramic: 6-20 µSv CBCT: 20-70 µSv Conventional CT: 314 µSv
  • 4. /7/744 CBCT vs. PanoramicCBCT vs. Panoramic The i-Cat CBCT Cephalometric CBCT image Cephalometric Panoramic image
  • 5. /7/755 ShortcomingsShortcomings Metal artifacts?Metal artifacts? Worse low contrast detectabilityWorse low contrast detectability Long scan times = motion artifactsLong scan times = motion artifacts Slightly Inferior quality to conventional CTSlightly Inferior quality to conventional CT Periodontal ligament spaces easily recognizable in the dental CT but not satisfactory in the CBCT CBCT
  • 6. /7/766 Applications of CBCTApplications of CBCT Great for pre-planning for implant surgeryGreat for pre-planning for implant surgery Virtual SurgeryVirtual Surgery Conventional CT diagnosis at 1/5 the doseConventional CT diagnosis at 1/5 the dose Tumor detectionTumor detection Airway visualizationAirway visualization
  • 7. /7/777 ConclusionsConclusions CBCT offers less dose than conventional CTCBCT offers less dose than conventional CT CBCT offers superior images and diagnosis toCBCT offers superior images and diagnosis to panoramicpanoramic More practical than a conventional CTMore practical than a conventional CT
  • 8. /7/788 ReferencesReferences Jaffray DA, Siewerdsen JH. Cone-beam computed tomography with a flat-panel imager: initial performance characterization. Med PhysJaffray DA, Siewerdsen JH. Cone-beam computed tomography with a flat-panel imager: initial performance characterization. Med Phys 2000;27:1311-232000;27:1311-23 Sukovic P. Cone beam computed tomography in craniofacial imaging.Orthod. Craniofacial Res. 6 (Suppl. 1), 2003; 31-36Sukovic P. Cone beam computed tomography in craniofacial imaging.Orthod. Craniofacial Res. 6 (Suppl. 1), 2003; 31-36 Holberg C, Steinhauser S, Phillip G, Rudzki-Janson I. Cone-Beam Computed Tomography in Orthodontics: Benefits and Limitations. JHolberg C, Steinhauser S, Phillip G, Rudzki-Janson I. Cone-Beam Computed Tomography in Orthodontics: Benefits and Limitations. J Orofac Orthop 2005;66:434-44Orofac Orthop 2005;66:434-44 Guerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging forGuerrero ME, Jacobs R, Loubele M, Schutyser F, Suetens P, van Steenberghe D. State-of-the-art on cone beam CT imaging for preoperative planning of implant placement. Clin Oral Invest (2006) 10:1-7preoperative planning of implant placement. Clin Oral Invest (2006) 10:1-7 Zhang Y, Zhang L, Zhu XR, Lee AK, Chambers M, Dong L. Reducing Metal Artifacts in Cone-Beam CT Images by PreprocessingZhang Y, Zhang L, Zhu XR, Lee AK, Chambers M, Dong L. Reducing Metal Artifacts in Cone-Beam CT Images by Preprocessing Projection Data. Int. J. Radiation Oncology Biol. Phy., Vol. 67,No. 3, pp. 924-932, 2007Projection Data. Int. J. Radiation Oncology Biol. Phy., Vol. 67,No. 3, pp. 924-932, 2007 Tsurumachi T, Honda K. A new cone beam computerized tomography system for use in endodontic surgery. International EndodonticTsurumachi T, Honda K. A new cone beam computerized tomography system for use in endodontic surgery. International Endodontic Journal, 40, 224-232, 2007Journal, 40, 224-232, 2007 Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IAB. Eur. Radiol. 8, 1558-1564 (1998)Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IAB. Eur. Radiol. 8, 1558-1564 (1998) Winter AA, Pollack AS, Frommer HH, Koenig L. Cone Beam Volumetric Tomography vs. Medical CT Scanners. NYSDJ 2005 June/JulyWinter AA, Pollack AS, Frommer HH, Koenig L. Cone Beam Volumetric Tomography vs. Medical CT Scanners. NYSDJ 2005 June/July 28-3328-33 Questions?
  • 9. March 6, 2008March 6, 2008 BureaBurea u ofu of RadioRadio logicalogica ll HealtHealt hh Cone Beam ComputedCone Beam Computed TomographyTomography
  • 10. NewTom 3G by AFP MercuRay by Hitachi 3D Accuitomo by J. Morita Cone-beamCone-beam UnitsUnits Galileos by Sirona I-CAT by ISI Iluma by IMTEC
  • 11. Source;Source; StuartStuart White-White- UCLAUCLA SchoolSchool ofof DentistrDentistr yy Comparative DosimetryComparative Dosimetry Effectivedose(µSv)
  • 12. Source;Source; StuartStuart White-White- UCLAUCLA SchoolSchool ofof DentistrDentistr yy Dental ApplicationsDental Applications Broad acceptance in dentistry last fiveBroad acceptance in dentistry last five yearsyears – Orthodontic treatment planningOrthodontic treatment planning – Dental implantsDental implants – Temporomandibular joints for osseousTemporomandibular joints for osseous degenerative changesdegenerative changes – Evaluation of wisdom teeth vs. mandibularEvaluation of wisdom teeth vs. mandibular nervenerve – DiseaseDisease
  • 13. Source;Source; StuartStuart White-White- UCLAUCLA SchoolSchool ofof DentistrDentistr yy Cephalometric AnalysisCephalometric Analysis
  • 14. Source;Source; StuartStuart White-White- UCLAUCLA SchoolSchool ofof DentistrDentistr yy Bureau IssuesBureau Issues How to regulate these sources?How to regulate these sources? – Appears that FDA has classified them as CTAppears that FDA has classified them as CT If CT, subject to QA requirementsIf CT, subject to QA requirements If CT, limited licensed technologistsIf CT, limited licensed technologists prohibited from operating unitprohibited from operating unit Your thoughts?Your thoughts?
  • 15. Source;Source; StuartStuart White-White- UCLAUCLA SchoolSchool ofof DentistrDentistr yy Suggested RegulatorySuggested Regulatory ApproachApproach Advise all CBCT registrants that FDAAdvise all CBCT registrants that FDA classifies as CT (Once we officiallyclassifies as CT (Once we officially confirm)confirm) Advise registrants that only the Dentist,Advise registrants that only the Dentist, Physician, Dental Hygienist(?) orPhysician, Dental Hygienist(?) or Diagnostic Technologist can operateDiagnostic Technologist can operate CBCTCBCT Provide registrants 90 days to developProvide registrants 90 days to develop and 180 days to implement alternative QAand 180 days to implement alternative QA program as permitted by N.J.A.C. 7:28-program as permitted by N.J.A.C. 7:28-

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